Response to: Psychiatric Morbidity Among Adolescents and Young Adults Who Contacted Specialised Gender Identity Services in Finland in 1996–2019: A Register Study

A study, led by Dr. Kaltiala, looked at Finnish national medical record data to see how often transgender youth used psychiatric services. Some news stories claimed the study showed that gender-affirming care (GAHT) harms mental health, but the study was not designed to answer this question.

Researchers used national health records to compare transgender youth who asked for gender-affirming care to cisgender youth. They checked if people had seen a psychiatrist before and after seeking GAHT, but only measured whether someone had ever had at least one psychiatric visit—not why they went, how often, or how serious their mental health concerns were.

Experts have criticized the study’s methods and its interpretation in numerous letters to the editor. Key issues include:

• The study ignored data on how many times people saw a psychiatrist, which could have given a better sense of mental health.

• The study cannot show that GAHT causes mental health problems. Just because two things happen together does not mean one caused the other.

• The study did not directly compare people who got GAHT with those who did not, or how individual mental health changed over time.

Looking at the data:

• Before medical transition, few transgender youth who later got GAHT had seen a psychiatrist.

• Psychiatrist visits increased after starting GAHT, likely because meetings with a psychiatrist are part of the process.

• Transgender youth who wanted GAHT but didn’t get it had high and steady rates of psychiatric visits all along, possibly because people with more mental health concerns had trouble getting care.

In short: The study shows transgender people are more likely to see a psychiatrist than cisgender people, but does not prove that gender-affirming care helps or harms mental health. Seeing a psychiatrist is not the same as having worse mental health, and accessing care should not be seen as a negative outcome.

For more details, read our full response linked below.

Acta Paediatrica - 2026 - Edmiston - Concerns Regarding Data Modelling and Interpretation .

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